By Opija Raduk

The Ebola outbreak in the Democratic Republic of Congo (DRC) is proving to be dangerous day by day. The World Health Organization (WHO) has now declared Ebola as Public Health Emergency of International Concern (PHEIC).

While most people have come to know Ebola after the current outbreak that started in August 2018, it should be known that the first case of Ebola in DRC was declared in 1976. The current outbreak is the 10th in the history of DRC.

Ebola got its name from Ebola River which is near the village where the first case was reported in 1976. Ebola means “Black River” in the local Lingala language among Congolese.

These remarks were made by Dr Ndahindwa Vedaste, a lecturer of Medicine at the University of Rwanda, during the 8th East Africa Social Science Translation (EASST) Summit held in Nairobi, Kenya.

Dr Ndahindwa making a presentation during the 8th East Africa Social Science Translation Summit

Dr Ndahindwa was presenting his research paper on the “Impact of Insecurity on the Ebola Response in DRC”. He regretted myriad challenges to Ebola response especially in conflict zones.

“The attacks in Katwa and Butembo Ebola Treatment Centres (ETCs) in February this year (2019) have slowed the process of containing the deadly virus. Acts like we have seen recently continue to frustrate the efforts made in the fight against Ebola,” Dr Ndahindwa complains.

According to Medecins Sans Fronteirers (MSF), DRC declared their 10th outbreak of Ebola in four decades in 2018. The outbreak is centred in the northeast of the country. With the number of cases now exceeding 2,500, it is by far the country’s largest-ever Ebola outbreak.

The WHO and MSF believe that contributing to the high numbers, is difficulty in identifying and following up contacts of people diagnosed with Ebola. Since the beginning of the epidemic, only around half of the new reported cases have been identified.

Others include contacts of previous confirmed cases before falling ill and seeking treatment, or dying without receiving proper treatment for Ebola.

For instance, the first eight months of the epidemic, until March 2019, more than 1,000 cases of Ebola were reported in the affected region. However, between April and June 2019, the number has since doubled, with a further 1,000 new cases reported in just these three months.

Subsequently, early June the number of new cases notified per week has remained high, averaging between 75 and 100 each week.

“One of the key challenges in this Ebola outbreak, and the main reason new unrelated cases keep appearing, is insecurity. The disease is spreading in conflict areas as communities are suspicious of international aid agencies,” Dr Ndahindwa revealed.

Dr Ndahindwa observes that the delay in preparedness and subsequent response could be attributed to several factors, including a breakdown of the surveillance system due to the security context.

“During attacks there are limitations on movement and access to health facilities becomes difficult,” he regrets.

“In the third week after burning the ETCs in Butembo and Katwa the main health facility, the average daily number of cases shot up by at least 6 Ebola virus disease (EVD) cases more than would have been expected if the attack was not there,” Dr Ndahindwa affirmed.

The lecturer of Medicine said the attacks put on standby medical activities in the epicentre of the Ebola epidemic in Butembo in the province of North Kivu.

The unidentified assailants of Butembo set some of the facilities including vehicles on fire. The blazes were contained, but the medical team were obliged to immediately terminate patients’ healthcare.

At the time of attack, there were 57 patients admitted in the treatment centre, 15 of whom were confirmed to have Ebola. There was no option but to release them.

Following these incidents, the medics have since evacuated their staff from the area for safety. This is pending a thorough analysis of the risks associated while continuing to provide medical care.

In such an environment, Dr Ndahindwa cautions that tracking and treating everyone who may have come into contact with Ebola becomes impossible.

The International Rescue Committee (IRC) advises that more community engagement is needed to build trust.

“The inability to build community trust has proven to be a major barrier to stopping the spread of this disease,” the IRC notes in a statement.

In late June 2019, another incidence occurred where angry crowds hurled rocks at a driver working with Ebola response team in Beni and set his vehicle on fire. Beni is also a health facility in the province of North Kivu bordering Uganda.

Even as the motives of the attacks remain unclear, the mistrust and violent attacks against the Ebola response show no signs of abating. On 13 July two Ebola healthcare workers were killed by unidentified assailants in Beni.

This means that there is an increased likelihood of the virus spreading if the high levels of insecurity continue to hamper the efforts to control the epidemic.